Saturday, February 24, 2007

Birth Story for Mary Kathleen "Kate" 2-24-04. I wrote this within weeks of Kate being born.

As background, I had been planning on an unmedicated birth using a midwife at a birthing center within the hospital. I was GBS+ so I knew needed IV antibiotics prior to birth. I was supposed to get 2 doses, 4 hours apart, before delivery. The midwife had told me that I could go into L&D triage, get the antibiotics, and then go home to labor more at home. I had also been having painless frequent contractions since about 32 weeks.

I woke up Monday morning (Feb 23 – 38 weeks, 2 days) with contractions that felt a little different. I was describing them to people as “gas pains.” I was only having 1-2 and hour, so I didn’t think much about it. At work that day I did feel a strong urge to wrap up a lot of loose ends. I left work a bit early and ran a bunch of errands... the vet, the post office, Sam’s Club, Blockbuster, car wash, and Target. The whole time I was having these “gas pain” contractions. They were coming more frequently, but I still did not think I was in labor. I got home and told Matt that I think I was having “false labor” pains. We had a frozen pizza for dinner, and then Matt encouraged me to go get in bed with a big glass of water to see if the contractions would subside. I got into bed and started timing contractions about 7pm. The first hour they were pretty erratic anywhere between 4 and 10 minutes apart. Between 8pm and 9pm they were coming more like 2-4 minutes apart and were strong enough to make me catch my breath. Matt saw me breathe through one of them, and it sent him into a tizzy! We hadn’t packed the hospital bag, so he started running around like a chicken with his head cut off! It was pretty entertaining! I kept telling him to relax as I still thought it was false labor. Everyone has false labor, right?

At 9pm Matt convinced me to call the midwife. I spoke to her at about 9:30pm and told her about the contractions saying they were becoming fairly regular but that I still wasn’t sure this was it. She told me to go get checked in triage just to make sure since I was GBS+. Not a minute after I hung up the phone with her, I had another contraction and *pop* my water broke while I was standing in the kitchen (about 9:45pm)! So I sat on the toilet while Matt finished packing. I wore a pair of his scrub bottoms with a hand towel stuffed between my legs (and several on the car seat also!) I was amazed at how much water would come out with each contraction. On the way to the hospital we called our parents and a few friends to let them know what was happening. The contractions got a lot stronger in the car, and I started my yoga vocal breathing with each of them. I was still just fine between contractions… laughing, joking, telling Matt to slow down, etc.

We got to the hospital and walked through the ER. Someone led us up to L&D triage. They offered me a wheelchair, but I really wanted to walk. I had several contractions on the way up and had to stop to breath through them. We got to triage, I changed into a hospital gown, a nurse hooked me up to a fetal heart rate monitor, and checked me… I was only 2cm! (By the way, the entire time I have fluid pouring out of me with each contraction! I really didn’t believe there could be that much fluid in there!) I spoke with the midwife on the telephone, and she told me that they wouldn’t admit me until I was “progressing” and she was present. She usually didn’t come to the hospital until someone is about 5cm. So about 10:45pm, Matt and I start walking the hospital halls. The contractions were pretty strong, but I had no problem recovering between them. We spent most of the time in the hallway of the birthing center as it was quiet and there was a big chair that I could rest in. Matt kept giving me sips of water. Big mistake! About midnight I was starting to feel nauseous at the end of each contraction. I also felt like lying down. We went back to triage. The contractions were definitely getting stronger and stronger, and I could tell I wasn’t as cheery between contractions. They started an IV for the antibiotics. Then I vomited… a lot. Afterwards I felt much better. They started the antibiotic, Matt convinced me to brush my teeth, and then he wanted to go call his mom. As soon as he left the contractions seemed to start coming one on top of the other. And the pain was getting pretty severe (although I still felt in control with my breathing… I pretty much just used my yoga vocal breathing… translation: loud moaning!). The pain for me was mostly in my hips. Felt a lot like a vice grip tightening around them. (The nurse told me the pain was my hips spreading to make room for the baby… *great, thanks, that makes me feel better*…) Because of the hip pain, I was uncomfortable lying on either side. It was also very uncomfortable lying on my back. Since being on my belly was out of the question, I spent a lot of the time on my knees with my head leaning against the elevated head of the stretcher. It felt like forever that Matt was gone.

The antibiotic finished at about 12:45am (it is now Tues, Feb 24th), Matt is back, and the nurse tells us our options. They won’t admit me to the birthing center until I am progressing more (but they haven’t checked me since I first arrived…), so our options are to go home and labor at home (which is what the nurse is encouraging us to do), stay in triage longer, or be admitted to a regular L&D room until I progress to the point that I can be admitted to the birthing center. I ask to be checked so that maybe I can go straight to the birthing center. The nurse says “no” because my water has broken and they don’t want to check “too much” and introduce any bacteria. She also says that when first time moms are only 2cm when their water breaks, the progression of labor is much slower than usual. She guesses that I am probably only 3-4cm dilated and that I have at least another 8-10 more hours of labor. When she said that, I LOST it! I started rolling and moaning and saying, “I want an epidural!” and “I can not do THIS for 8 more hours!” Everyone was encouraging me that I wanted to go unmedicated, but I was convinced at that point that I WOULD NOT be able to continue with contractions like this for much longer, especially if I was only in early labor… what would active labor and transition be like?!?

Matt talks to the midwife on the phone (tells her that I am begging for the epidural. He later tells me that he was thinking “C’mon, Kristen, you wanted this unmedicated birth so bad, and you can’t even make it to 4cm without asking for an epidural?!?) So we decide to be admitted to L&D. I agreed to NOT get the epidural until I had tried using the rocker and shower in L&D (but I still was convinced that I wouldn’t be able to do it). The nurse suggests that while we are waiting on a room that I change position and stand in my triage cubbyhole. I get up, and the next contraction is almost unbearable. I am standing and try leaning into the stretcher, but my legs are shaking and I literally can’t stand up. I go down on my knees, and Matt has to support me to keep me from lying on the floor. I remember thinking that it would feel good to lay down in a fetal position on the cool floor… a dirty, hospital floor! Yuck! Matt gets a chair for me to lean into on the next contraction. That contraction hits, and *bam* I feel that rectal pressure that everyone talks about! I call out to the nurses (the triage nurse is giving report to the L&D nurse) that they really need to check me because I am feeling rectal pressure and feel like I need to have a BM. The nurses give each other a look and tell me that I am fine and that a warm shower will help. We walk to my room (I have 2 more almost unbearable contractions in the hall with that same rectal pressure.) We get to the room (about 1:30am), and I go straight to turn on the shower. I am ready to strip down and get in when the nurse says that she wants to check a fetal heart rate first. I walk over to the bed, and have another contraction. Suddenly I have even more rectal pressure and I *have* to push. I start this grunting (pretty, I know!) thing and the nurse says, “You do seem a little pushy, lets check you.” I lay down, she checks, and I am 9cm dilated! The next contraction comes and the urge to push is almost unbearable. She tells me not to push, Matt is trying to get me to breath, and I am, “Chu, chu… uuuughhh.” I can’t help but push.

The nurse grabs a resident, sets up quickly, and they let me start pushing. I wanted to push on my side. They let me push on my side through 2 contractions, then convince me to lay on my back. My instinct was to do small, grunting pushes (which is what they had advised in our Advanced Labor class), but everyone was telling me to do the push and hold for 10 seconds thing. I didn’t really think it was the time to argue, so I kinda did half and half. Held the push for about 6 seconds then did short grunty pushes. I pushed through about 4 contractions and out the baby came! To me, it actually felt really good to push. There was some burning and a quick sharp pain as her head came out, but it wasn’t too bad at all. The baby came out with a hand on her cheek, so I had a second degree laceration laterally into my labia. Funny thing is that she always had her hands at her face in the ultrasounds and now always has her hands up by her face. She can’t stand to be swaddled with her arms down.

Mary Kathleen was born on Tuesday, February 24, 2004 at 1:50am. 20 minutes after we got to our room… just over 3 hours after we got to the hospital. She was 7lbs 6oz and 20.5in. The midwife showed up about 10 minutes after she was born. We had to stay in the hospital for the full 48 hours because I was GBS+. Kate had to have blood cultures drawn out of her little wrists because she came so fast I didn’t get the second dose of antibiotics (in retrospect I would have refused the cultures). The pediatrician heard a “click” on her heart sounds when he did her assessment, so at 12 hours old she had to have an echocardiogram done (ultrasound of the heart). That came back normal.

I am a bit disappointed that I didn't get to have the birthing center experience that I wanted and a little miffed that I spent all of active labor and transition on a stretcher in triage. I was also really looking forward to using the jacuzzi tub during labor, but I suppose that 3 hours of labor in triage is better than 15 hours of labor in a jacuzzi! Also, I think that I would not have started asking for the epidural if I had known how far I had progressed. I was most likely already in transition at that point, but I was being told I was still in early labor. Since I went from 2cm to delivered in just over 3 hours, it was considered a precipitous birth. I wonder what my next birth will be even faster.